期刊
HEPATOBILIARY & PANCREATIC DISEASES INTERNATIONAL
卷 16, 期 2, 页码 215-221出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/s1499-3872(16)60171-6
关键词
pancreatic head cancer; pancreaticoduodenectomy; borderline resectable
资金
- National Natural Science Foundation of China [81071775, 81272659, 81101621, 81172064, 81001068, 81272425]
- Key Projects of Science Foundation of Hubei Province [2011CDA030]
- Research Fund of Young Scholars for the Doctoral Program of Higher Education of China [20110142120014]
BACKGROUND: The treatment of borderline resectable pancreatic head cancer (BRPHC) is still controversial and challenging. The artery-first approaches are described to be the important options for the early determination. Whether these approaches can achieve an increase RO rate, better bleeding control and increasing long-term survival for BRPHC are still controversial. We compared a previously reported technique, a modified artery-first approach (MAFA), with conventional techniques for the surgical treatment of BRPHC. METHODS: A total of 117 patients with BRPHC undergone pancreaticoduodenectomy (PD) from January 2013 to June 2015 were included. They were divided into an MAFA group (n=78) and a conventional-technique group (n=39). Background characteristics, operative data and complications were compared between the two groups. RESULTS: Mean operation time was significantly shorter in the MAFA group than that in the conventional-technique group (313 vs 384 min; P=0.014); mean volume of intraoperative blood loss was significantly lower in the MAFA group than that in the conventional-technique group (534 vs 756 mL; P=0.043); and mean rate of venous resection was significantly higher in the conventional-technique group than that in the MAFA group (61.5% vs 35.9%; P=0.014). Pathologic data, early mortality and morbidity were not different significantly between the two groups. CONCLUSIONS: MAFA is safe, simple, less time-consuming, less intraoperative blood loss and less venous resection, and therefore, may become a standard surgical approach to PD for BRPHC with the superior mesenteric vein-portal vein involvement but without superior mesenteric artery invasion.
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